Addiction medicine has been 'practically untaught' for decades, but that's starting to change.ELEVATEPD/2014/62015-10-05 JG: removed external advertisements from PDF at author's reques

Klimas, Jan

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15-07-29 10:38 AM‘Wake up the doctors’ and teach them addictions | Canadian Healthcare Network - PhysiciansPage 1 of 2http://www.canadianhealthcarenetwork.ca/physicians/discussions/opin…=EmailMarketing&utm_medium=email&utm_campaign=Physician_NewsletterSearchThe online home of Edit PostPhysicians  »  Discussions  »  Opinion‘Wake up the doctors’ and teach them addictionsAddiction medicine has been 'practically untaught' for decades, but that's starting to changeWRITTEN BY DR. JANO KLIMAS (PHD) ON JULY 29, 2015 FOR CANADIANHEALTHCARENETWORK.CARead more articles on: drug abuse • addictionEmail Print Text size Comment“Wake up the doctors and educate the people,” Dr. Ernest Bishop, a clinical professor of medicine at NewYork Polyclinic Medical School, wrote in the American Journal of Public Health. “Medical, legislative andpopular ideas are all in error.”The article was titled “Narcotic drug addiction: A public health problem” and the year was 1919. Dr. Bishopargued that addiction is not a vice but a disease that requires treatment. However, there were fewmedications to treat it back then. He also noted “addiction is practically untaught in the school.”Little did he know that it would take a century for things to start changing. Although we have effectivemedications now, they are underused because doctors don’t know about them.Nor is the drug problem any less pressing than Dr. Bishopfelt it to be nearly 100 years ago. According to StatisticsCanada, in 2012 approximately 21.6% of Canadians(about six million people) met the criteria for having had asubstance use disorder during their lifetime.Furthermore, in the Canadian Journal ofAddiction(September 2014), Dr. Peter Selby, chief of the addictions program at the Centre for Addiction andMental Health (CAMH) in Toronto, and colleagues noted the prevalence of substance abuse in Canada isabout 11%.However, Dr. Selby and his coauthors went on to note that although Canadian family physicians cited it asthe third most important area of competence for a newly practising family physician in a recent surveyundergraduate training in addiction medicine in Canadian medical schools “is minimal to non-existent.”Among residency programs, the researchers noted, only psychiatry requires any dedicated exposure toaddiction care. As for fellowship programs, there are a few scattered programs for psychiatry residents; afellowship for family medicine residents at St. Joseph’s Health Centre in Toronto; and only two programsaccredited by the American Board of Addiction Medicine (out of 27 in North America), at CAMH and at SaintPaul’s Hospital in Vancouver.Most programs have only one to three spots per year, but the St. Paul’s initiative brings something differentto the table.The St. Paul’s Hospital Goldcorp Fellowship in Addiction Medicine was created in 2012 with a $3-milliondonation from Goldcorp Inc. and it is now one of the largest fellowships in North America that trains doctorsto become addiction specialists. The program accepts six trainees per year who can come from any medicalbackground, typically psychiatry, internal medicine and family medicine. One position for nursing isavailable.In addition to the clinical fellowship, there is an addiction medicine research fellowship, as well as rotationsPhysicians Pharmacists Nurses & Nurse Practitioners Healthcare ManagersProfession Santé.caUndergraduate training inaddiction medicine in Canadianmedical schools ‘is minimal to non-existent.’Search for...News Clinical Your Practice Inter-Professional CME Classifieds Life & Travel Discussions Technology Forums15-07-29 10:38 AM‘Wake up the doctors’ and teach them addictions | Canadian Healthcare Network - PhysiciansPage 2 of 2http://www.canadianhealthcarenetwork.ca/physicians/discussions/opin…=EmailMarketing&utm_medium=email&utm_campaign=Physician_NewsletterProfession Santé.caSite MapAbout Us Contact Us Advertising Inquiries Privacy/Legal Terms & Conditionsfor medical students and residents with the St. Paul’s addiction medicine consult team.“We’re not just training very senior physicians; the fellowship also enables the supervision of more juniortrainees,” director Dr. Evan Wood noted in the St. Paul’s Hospital Foundation’s magazine Promise(Fall/Winter 2014). “We’ll have over 80 physicians and trainees go through the program over the next year orso. Those trainees will bring a great deal of competency in this area to other areas, from medicine to mentalhealth.”The program’s success hasn’t gone unnoticed. The Irish Research Council recently sent me to Vancouver toconduct a three-year study of the mechanisms of the fellowship.Although Ireland reportedly has the third highest level of overdose deaths per capita in Europe, Irish medicalstudents get only two hours of addiction instruction over four years of medical school.My study—including information from interviews with past fellows, together with a review of the scientificliterature—will help inform an expert panel developing standards for education of doctors in addictionmedicine in Ireland, and possibly worldwide.Dr. Bishop would have approved.Dr. Jano Klimas (PhD) is a research fellow in medical schools at University College Dublin and theUniversity of British Columbia. He completed his doctoral training in Slovakia and postdoctoral training inIreland where he studied primary care of patients in opioid agonist treatment.Email Print CommentPost a commentNote: Your name will be displayed with your comments.SubmitOur mission statement: To be the one-of-a-kind onlinedestination for healthcare professionals, where they willlearn, engage and grow individually and inter-professionallyto advance better health for all Canadians.Copyright 2009-2015 Rogers Media Inc. All rights reserved.Enter text here

'Wake up the doctors' and teach them addictions

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